Provider Demographics
NPI:1316514425
Name:WILLOW TREE SENIOR CARE INC
Entity type:Organization
Organization Name:WILLOW TREE SENIOR CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:INGA
Authorized Official - Middle Name:
Authorized Official - Last Name:GALADZHYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-426-9900
Mailing Address - Street 1:10722 WHITE OAK AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:GRANADA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91344-4664
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10722 WHITE OAK AVE STE 3
Practice Address - Street 2:
Practice Address - City:GRANADA HILLS
Practice Address - State:CA
Practice Address - Zip Code:91344-4664
Practice Address - Country:US
Practice Address - Phone:818-426-9900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-07
Last Update Date:2021-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based